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August 14, 2008 NEWSLETTER
Doug Wojcieszak, Founder & Spokesperson
Contact phone/e-mail address: 618-559-8168; doug@sorryworks.net
THIS WEEK'S EDITION:
- Sorry Works! Editorial: Disclosure - What should it mean in practice for patients, families, and providers?
- Sorry Works! Presentations - California
- Disclosure...a ways to go in Kansas City
- United Kingdom still struggling with meaning of disclosure
- Sorry Works! in Nigeria
SORRY WORKS! EDITORIAL: DISCLOSURE - WHAT SHOULD IT MEAN FOR PATIENTS, FAMILIES, AND PROVIDERS?
What should disclosure mean in practice? What should patients and families do post- adverse event? What should providers do? The lack of connectivity between these two groups post-adverse event are the reason for so many med-mal lawsuits, both legitimate and non-meritorious. Here's what needs to happen:
1) Patients and families must always first return to their providers. Give your provider(s) a chance to meet and talk with you. Ask for a meeting where plenty of time is set aside in a quiet place to discuss all necessary issues. Be prepared for the meeting with a list of questions and, if necessary, concerns. If time permits, write down this information and be ready to share it with your providers verbally and in writing.
2) Patients have a right to empathy and concern from their providers. "We're sorry this happened to you...we're sorry you feel this way."
3) Patients should request an investigation of said adverse event to find out what exactly happened. Patients should receive a date/time certain of when providers will follow back with them to share the results of the investigation.
4) If the investigation shows an error occurred, the patient should request - and receive - an apology, admission of mistake(s), discussion of how the mistake will be prevented in the future, and a discussion of compensation (monetary and non-monetary.)
Providers often complain that patients and families run to a trial lawyer at the first sign something is wrong. They believe they never get a chance to tell their side of the story and, wham, they are hit with a medical malpractice lawsuit. And, then, their lawyer advises them not to speak about the case. Maddening, indeed.
Patients need to be encouraged to return to their providers. Doctors need to let patients and families know the door is always open. We have an entire chapter on this subject (Chapter 8) in the new Sorry Works! Book http://www.sorryworks.n et/booksoon.phtml. However, doctors need to take advantage of this opportunity! They need to be ready to listen and not be defensive. Doctors need to be empathetic and be ready to initiate credible investigations. Doctors also need to be ready to share the results of their investigations without hiding behind peer- review protections. Finally, and most importantly, doctors need to be ready to own and remedy mistakes. If doctors can do these things they will at the minimum create great evidence for themselves should any case move forward to litigation. However, if a doctor is not ready to talk when an aggrieved patient comes calling, then great evidence will be created for the plaintiff's attorney!
Patients have a right to information, and doctor have a duty to provide information. When the two sides learn to work together and communicate effectively, much litigation can be avoided, especially in cases where legitimate medical errors occurred!
SORRY WORKS! PRESENTATIONS - CALIFORNIA
Over the last month Sorry Works! has made successful presentations to two large medical centers in California, one in Los Angeles and one in the northern part of the state. Even though California has MICRA, liabilty is still a major concern for providers in the Golden State...and Sorry Works! has the answers for them. Sorry Works! can provide greater control over liabilty for your hospital, medical practice and/or insurance company too.
Sorry Works! presentations are being booked for the fall, winter, and next spring. If you are interested in a Sorry Works! presentation, call 618-559- 8168 or e-mail doug@sorryworks.net. But don't delay - dates are filling quickly!
DISCLOSURE....A WAYS TO GO IN KANSAS CITY
Below is an article that recently appeared in the Kansas City Business Journal on disclosure and apology. Seems like most hospitals in the Kansas City area support the concept, but there is work to do on implementing actual, working disclosure programs. The same could be same said for most areas of the United States and elsewhere in the world. We still have work to do! Read below!
Sorry seems to be the least litigious word for hospitals in malpractice
Kansas City Business Journal
by Rob Roberts Staff Writer
U.S. hospitals are starting to counter rising malpractice costs and awareness of medical errors through a new type of admission -- of responsibility.
In the Kansas City area, however, it's tough to get hospital officials to even disclose whether they've implemented error- disclosure policies, much less discuss the details.
Only four of 10 area hospital systems responded to a Kansas City Business Journal survey asking whether they had adopted full disclosure, which is generally delivered with prompt apologies and settlement offers.
All four respondents -- Shawnee Mission Medical Center, HCA Midwest Health System, Saint Luke's Health System and The University of Kansas Hospital -- said they adopted such policies years ago. But all were unable, or unwilling, to provide statistics comparable to those announced recently by the University of Illinois Medical Center, which launched its full-disclosure policy about two years ago. Since then, The New York Times reported last month, the Illinois medical center has fessed up to preventable errors and apologized in 37 cases, resulting in only one lawsuit.
"I do know that we keep track of all those things very carefully," Dr. Lee Norman, chief medical officer at KU Hospital, said when asked for comparable information relating to his institution. But the hospital ultimately declined to disclose the information.
Saint Luke's spokeswoman Kerry O'Connor said: "Disclosure is such a part of our culture, we've not formally tracked it to date." Sara Smith, a spokeswoman for HCA Midwest, said: "We do not have data on the specific number of lawsuits or settlements." And Sam Turner, CEO of Shawnee Mission Medical Center, said he didn't have the data but could "try to get that information at a later date."
Turner said he was not trying to be evasive. But a subsequent exchange involving him and a malpractice lawyer suing the hospital may help explain why hospital officials are reticent to talk publicly about anything related to medical errors.
In January, Jim Bartimus of Bartimus Frickleton Robertson & Gorny PC filed a lawsuit on behalf of Ronald Deffenbaugh, who fell from an X- ray table at Shawnee Mission Medical Center, fracturing a vertebra near the base of his skull and almost severing his spinal cord in June 2007. Deffenbaugh, who had just sold Deffenbaugh Industries Inc. for an estimated $300 million, is now a ventilator-dependent quadriplegic.
Bartimus contends that Deffenbaugh was injured after being left sedated, unrestrained and unattended on the X-ray table but that the medical center never has acknowledged responsibility. Turner said he could not discuss litigation.
"But when the facts come out, it will be clear that we were consistent with our (full-disclosure) philosophy in that case," Turner said.
Informed of Turner's statement, Bartimus said: "That's just horse (manure), and I like Sam.
"It was obvious that the guy fell from a table; they acknowledged that," Bartimus said. "But we (weren't told) any of the facts -- even the absolutely egregious fact that, after he fell, these two 140-pound nurses picked him up by his head, shoulders and feet and plopped him back on the table."
Bartimus, who represents plaintiffs in about 30 medical-error cases a year, said he's heard the topic of hospital disclosure policies "being bandied around" in the Kansas City market.
"But (hospitals) have been so ingrained with risk management and pressure from insurance companies to 'deny, deny, deny; we'll fight this out' that it's just not something that's coming natural to these folks," Bartimus said.
Ironically, every hospital that has resisted the deny-and-defend mentality has reaped "good PR," said Doug Wojcieszak, who founded the Sorry Works! Coalition, based in Glen Carbon, Ill., in 2005. More important, Wojcieszak said, full disclosure, apologies and early settlement offers defuse anger among error victims and reduce the number of malpractice cases filed against hospitals.
With 1,500 members in the medical, legal, insurance and patient- advocacy fields, the Sorry Works! Coalition recently published a book to help hospitals implement the full disclosure/early offer concept. But Wojcieszak said he was not aware of any Kansas City- area hospitals truly embracing it. Therefore, he encouraged local patients to "demand information" of their hospitals regarding their disclosure policies and compliance measures.
To help pave the way toward a new, less concealing culture, the Sorry Works! Coalition also has encouraged states to adopt "apology laws," which allow doctors to make prompt apologies for unfortunate or unexpected outcomes, without fear of their use in court as admissions of liability. So far, 34 states, including Missouri, have passed such laws.
Dr. Richard Hellman, a North Kansas City endocrinologist and former president of the Metropolitan Medical Society of Greater Kansas City, said doctors generally favor disclosing and apologizing for errors.
"But I don't know about the (area) hospitals," said Hellman, who has been on staff at several. "I can't speak for (North Kansas City Hospital). But I can tell you what I would encourage them to do -- and have -- and that is come clean early."
Even Tom W. Wagstaff of Wagstaff & Cartmell LLP, which represents Saint Luke's and other hospital defendants, said full disclosure is the best policy.
"I've done this for 36 years, and I've never counseled physicians or health care providers to deny and defend," Wagstaff said.
Turner said Shawnee Mission Medical Center shed that posture before 2001 because it wanted to earn the community's trust and not appear hypocritical to its staff.
"In the past, it wasn't a matter of wanting to hide anything," Turner said.
"It was just that everybody was so concerned about liability and litigation that we just weren't as forthcoming as probably we should have been. So we made a policy that says: However major or mundane the injury or near-injury, we will disclose it."
Smith said HCA recently updated its disclosure policy. It now requires its hospitals to issue apologies for preventable errors and waive fees for related complications.
"While this (waiver) may seem obvious, this requirement sets HCA apart from many other health care organizations," Smith said.
rroberts@bizjournals.com | 816-421-5900
UNITED KINGDOM STILL STRUGGLING WITH MEANING OF DISCLOSURE
Like everywhere else in the world, it appears the healthcare and legal systems in the United Kingdom are still struggling with disclosure and apology. See below for link for press release written by a patient's group asserting that the United Kingdom's NHS issued a circular that may have confused empathy with true apology and also implies that empathy may construe legal liability. Indeed, there is much need for education on this topic. Empathy is always appropriate and will never get you in trouble, and when you made a mistake saying you made a mistake as quickly as possible with the intention of fixing the problem is the best way to avoid litigation. Paste this link into your browser:
http://www.avma.org.uk/data/files/pages/press_release__nhs_chall enged_over_being_open.pdf.
SORRY WORKS! IN NIGERIA!
Sorry Works! is popping up everywhere today, including Nigeria! Read below for a very good article on customer service basics that gives a nice plug to Sorry Works! Definitely worth positing this article in the doctors' and nurses' lounges. Read below.
Published 7/19/2008 2:04:00 AM
Punch On The Web - Nigeria's Most Widely Read Newspaper
How to restore customer confidence
Agency reporter
Every day things go wrong in the service world, and we are faced with the challenge of turning service failures into service recoveries.
But what does it really take to restore customer confidence and regain goodwill?
Here's uncovering a series of simple, but remarkably effective strategies that will unequivocally position any organisation to keep customers coming back after even the worst has happened. Each of these strategies is scientifically proven and surprisingly easy to execute.
Courtesy- Certainly, anyone in the position of interacting with customers must be friendly, helpful, polite, courteous, and flexible. These attitudes and behaviors are not just nice, but they are indeed expected. But when it comes to complaint handling specifically, we know that employee politeness while addressing the issue helps diffuse the problem in the customer's mind. Research has found that when customers feel like they are being treated with respect, dignity, and sensitivity by employees, they feel a sense of justice and fairness from the company.
As simple as it may sound, politeness is a tangible asset that can positively impact customer satisfaction with service recovery. If you solve the customer's issue, but are rude or indifferent in the process, you can still negatively impact the relationship. Simply put, when your employees are polite and courteous, customers will experience more satisfaction and reward you with stronger loyalty.
Apology- Making an apology to customers after things go wrong is positively related to satisfaction with the recovery. When a service employee apologises to a customer, she/he conveys politeness, courtesy, concern, effort, and empathy and this goes a long way. Research has also shown that a genuine apology can actually strengthen a customer's emotional bond to a company, leaving him or her more emotionally connected than customers who never experienced a problem.
It is also well known by experts that when an apology is perceived as genuine, customer satisfaction increases 10 - 15%. A revolutionary program appropriately called "Sorry Works" in oversea countries, particularly in the United Kingdom and USA, encourages doctors and hospitals to apologise quickly when mishaps occur and to offer a fair settlement upfront to families and their attorneys.
Offer your customers a heartfelt apology after a service failure and you will not only restore customer confidence and regain goodwill, but you should also realise the benefits of reduced litigation expenses and claims costs.
Justification- A vital but often overlooked element of customer recovery is to provide an explanation for how or why the problem happened.
Taking the time to explain to a customer what might have caused the problem helps organisations re-establish trust.
Experts in customers service delivery say "In many cases, a clear, believable explanation as to why the policy or performance is reasonable, will at least mollify the customer and, in some case, satisfy him or her."
Source: Google small business.co
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